Topotecan Injection

IMPORTANT WARNING:

Topotecan injection should be given only in a hospital or clinic under the supervision of a doctor with experience in the use of chemotherapy medications for cancer.

Topotecan injection may cause low levels of white blood cells in the blood. This increases the risk that you will develop a serious infection. You should not receive topotecan injection if you already have a low number of white blood cells. Your doctor will order laboratory tests regularly before and during your treatment to check whether your body has enough white blood cells. Tell your doctor and pharmacist if you are taking carboplatin (Paraplatin), cisplatin (Platinol), other chemotherapy medications, or filgrastim (Neupogen). If you experience any of the following symptoms, call your doctor immediately: fever, sore throat, chills, cough, abdominal pain, or other signs of infection.

Talk to your doctor about the risks of using topotecan injection.

WHY is this medicine prescribed?

Topotecan is used to treat ovarian cancer (cancer that begins in the female reproductive organs where eggs are formed) and lung cancer that have spread and did not improve after treatment with other medications. It is also used together with other medications to treat cervical cancer (cancer that begins in the opening of the uterus [womb]) that has not improved or has come back after other treatments. Topotecan is in a class of medications called topoisomerase type I inhibitors. It works by killing cancer cells.

HOW should this medicine be used?

Topotecan comes as a liquid to be given intravenously (into a vein) over 30 minutes by a doctor or nurse in a hospital or clinic. When topotecan injection is used to treat ovarian or lung cancer, it is usually given once a day for 5 days in a row every 21 days. When topotecan injection is used to treat cervical cancer, it is usually given once a day for 3 days in a row every 21 days. You will probably receive at least 4 cycles of treatment since it may take a while to tell if your condition has responded to the medication.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?

Before receiving topotecan injection,

tell your doctor and pharmacist if you are allergic to topotecan injection, any other medications, or any of the ingredients in topotecan injection. Ask your pharmacist for a list of the ingredients.

tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section.

tell your doctor if you have or have ever had kidney disease.

tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while you are receiving topotecan injection. Talk to your doctor about birth control methods that you can use during your treatment. If you become pregnant while receiving topotecan injection, call your doctor immediately. Topotecan injection may harm the fetus.

tell your doctor if you are breast-feeding. You should not breast-feed while you are receiving topotecan injection.

if you are having surgery, including dental surgery, tell the doctor or dentist that you are receiving topotecan injection.

you should know that topotecan injection may make you feel very tired or weak. Do not drive a car or operate machinery until you know how this medication affects you.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do IF I FORGET to take a dose?

Call your doctor right away if you are unable to keep an appointment to receive a dose of topotecan injection.

What SIDE EFFECTS can this medicine cause?

Topotecan may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

nausea

vomiting

diarrhea

constipation

loss of appetite

stomach or back pain

mouth sores

headache

thinning or loss of hair

redness or bruising at the site where the medication was injected

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:

Topotecan may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch ] or by phone [1-800-332-1088].

What should I do in case of OVERDOSE?

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

• sore throat, fever, chills, and other signs of infection

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Brand Names

• Hycamtin®

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Can we help answer your questions?

Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.